Irritable bowel syndrome is the usual medical diagnosis for unexplained gastrointestinal symptoms typically presenting with abdominal pain and accompanying stool changes. With a global prevalence estimated at 4.1%,1 irritable bowel syndrome (IBS) incurs significant health care costs.2
A personalized approach using pharmacologic, dietary and psychological interventions is recommended for IBS sufferers3 however, reduced Quality Of Life (QOL), sometimes significant disability, and impaired workforce productivity4 leaves many IBS sufferers dissatisfied with their medical care5 which necessitates the need for other approaches to IBS treatment.6
The four IBS subtypes diagnosed by Rome IV criteria7 are:
IBS-C constipation predominant.
IBS-D diarrhoea predominant.
IBS-M alternating diarrhoea and constipation.
IBS-U unspecified, having variable symptoms.
IBS is a gut-brain interaction disorder8 with 50% of sufferers experiencing just gastrointestinal symptoms.9 Co-occurrence with anxiety / depression occurs in 40-80% of IBS sufferers10 and is associated with more severe symptoms, reduced QOL, and increased physical and mental distress.11 Serotonin (5-hydroxytryptamine), a major pathophysiogenic factor in IBS, has a prominent role in controlling gastrointestinal motility.12
IBS, a chronic disease, is not well understood however, we do have some established facts. IBS sufferers experience varying degrees of:
Altered gastrointestinal motility13
Increased intestinal permeability14
Visceral hypersensitivity, and low-grade inflammation15
A pathogenesis of gastrointestinal infection has been identified in up to 30% of IBS cases.16
Small intestinal bacterial overgrowth (SIBO) - in up to 78% of sufferers17
Fungal dysbiosis18
Dysbiotic commensal bacterial communities are implicated19 and differ between IBS subtypes20
Microbiome beta diversity alteration during individualized homeopathy (I-HOM) treatment (for MS) has been documented.21
Homeopathy Gastroenterological complaints are commonly seen in professional homeopathic practice.22
Systematic review showed a little overall IBS symptom improvement after homeopathic treatment23 but, as all pharmacologic and non-pharmacologic IBS studies are low quality24 certainty of evidence is low.
To date, two systematic reviews of homeopathy in the treatment of IBS were conducted in 2019 - Peckham et al.,25 found inconclusive evidence for efficacy or safety, and Pacheco et al.,26 noted very low certainty of evidence, but overall self-reported symptom improvement.
A 2023 double-blind randomized, placebo-controlled trial (Das et al., ) found Individualized homeopathy acted significantly over placebo with group differences in IBS-QOL questionnaire total scores, and IBS severity scores.27
The following SNAPSHOT formed part of my 2023 conference paper Hormonal disorders and homeopathy in elite female athletes presented (on my behalf) at the XIII Australian homeopathic conference, Brisbane, 2023.
Amelioration of the presenting symptoms when accompanied by the return of old, suppressed symptoms (in this case peri-oral dermatitis) as the general overall condition improves (in this case strong respiratory, and medium intensity irritable bowel disease symptoms) indicates deep and positive change occurring within the defence system, in accordance with Direction of Cure theory.28293031
Chronic disease under classical homeopathic treatment which on improvement brings back the previously suppressed acute inflammatory states with fever indicates a return of the ability to produce and mount efficient defense.32
This, my first ever conference paper, was well received by serious homeopaths including international medical doctors, some of whom took the time to make personal contact, bless them. Delegate feedback, provided by the conference organizers, contained two hostile, anonymous comments which included ‘just some cases with too much research’ and ‘boring.’
Constructive feedback, positive or critical, is super helpful and a normal part of professional life. Of course I support the entitlement of everyone to their own opinions however, unconstructive (and did I mention anonymous) statements about a paper documenting years’ of hard won alleviation of long-term chronic disease/s was pointless and unprofessional - assuming these delegates were registered homeopaths that is…
Disparagement is a well established take-down tactic of professional homeopathy.33 At the beginning of the twentieth century homeopathy was well accepted in Australia,34 including by homeopaths… Upon receiving this ‘gracious feedback’ (yes, that’s what the conference organizer called it) I was reminded of the 2018 conclusion that Australian homeopathy is a profession in undoubtable decline.35
Sperber et al., 2021. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology. Jan;160(1):99-114.e3. Available from https://pubmed.ncbi.nlm.nih.gov/32294476/
Canavan et al., 2014. Review article: the economic impact of the irritable bowel syndrome. Alimentary Pharmacology and Therapeutics. Nov;40(9):1023-34. Available from https://pubmed.ncbi.nlm.nih.gov/25199904/
Manning et al., 2020. Therapy of IBS: Is a Low FODMAP Diet the Answer? Frontiers in Psychiatry. Aug 31;11:865. Available from https://pubmed.ncbi.nlm.nih.gov/33110411/
Paré et al., 2006. Health-related QOL, work productivity, and health care resource utilization of subjects with irritable bowel syndrome: baseline results from LOGIC (Longitudinal Outcomes Study of Gastrointestinal Symptoms in Canada), a naturalistic study. Clinical Therapeutics. Oct;28(10):1726-35; discussion 1710-1. Available from https://pubmed.ncbi.nlm.nih.gov/17157129/
Sabaté et al., 2020. Expectations of IBS patients concerning disease and healthcare providers: Results of a prospective survey among members of a French patients' association. Clinics and Research in Hepatology and Gastroenterology. Nov;44(6):961-967. Available from https://pubmed.ncbi.nlm.nih.gov/32205115/
Mousavi et al., 2020. An update on efficacy and safety considerations for the latest drugs used to treat irritable bowel syndrome. Expert Opinion on Drug Metabolism and Toxicology. Jul;16(7):583-604. Available from https://pubmed.ncbi.nlm.nih.gov/32380874/
Drossman & Hasler, 2016. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. May;150(6):1257-61. Available from https://pubmed.ncbi.nlm.nih.gov/27147121/
Patel et al., 2021. Review of Treatment Options for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation. International Journal of General Medicine. Apr 21;14:1457-1468. Available from https://pubmed.ncbi.nlm.nih.gov/33907450/
Hausteiner-Wiehle & Henningsen, 2014. Irritable bowel syndrome: relations with functional, mental, and somatoform disorders. World Journal of Gastroenterology. May 28;20(20):6024-30. Available from https://pubmed.ncbi.nlm.nih.gov/24876725/
Simpson et al., 2020. Feeling down? A systematic review of the gut microbiota in anxiety/depression and irritable bowel syndrome. Journal of Affective Disorders. Apr 1;266:429-446. Available from https://pubmed.ncbi.nlm.nih.gov/32056910/
Prospero et al., 2021. Somatization in patients with predominant diarrhoea irritable bowel syndrome: the role of the intestinal barrier function and integrity. BMC Gastroenterology. May 22;21(1):235. Available from https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01820-7
Vahora et al., 2020. How Serotonin Level Fluctuation Affects the Effectiveness of Treatment in Irritable Bowel Syndrome. Cureus. Aug 19;12(8):e9871. Available from https://pubmed.ncbi.nlm.nih.gov/32968548/
Mujagic et al., 2015. The Experience Sampling Method--a new digital tool for momentary symptom assessment in IBS: an exploratory study. Neurogastroenterology and Motility: the official journal of the European Gastrointestinal Motility Society. Sep;27(9):1295-302. Available from https://pubmed.ncbi.nlm.nih.gov/26100684/
Shulman et al., 2014. Associations among gut permeability, inflammatory markers, and symptoms in patients with irritable bowel syndrome. Journal of Clinical Gastroenterology. Nov;49(11):1467-76. Available from https://pubmed.ncbi.nlm.nih.gov/24435814/
Rijnaarts et al., 2021. Subtypes and Severity of Irritable Bowel Syndrome Are Not Related to Patients' Self-Reported Dietary Triggers: Results From an Online Survey in Dutch Adults. Journal of the Academy of Nutrition and Dietetics. Mar 2:S2212-2672(21)00028-9. Available from https://pubmed.ncbi.nlm.nih.gov/33674208/
Schwille-Kiuntke et al., 2011. Postinfectious irritable bowel syndrome: follow-up of a patient cohort of confirmed cases of bacterial infection with salmonella or Campylobacter. Neurogastroenterology and Motility. 30 August 2011. Available from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2982.2011.01779.x
Ghoshal & Ghoshal., 2017. Small Intestinal Bacterial Overgrowth and Other Intestinal Disorders. Gastroenterology Clinics of North America. Mar;46(1):103-120. Available from https://pubmed.ncbi.nlm.nih.gov/28164845/
Botschuijver et al., 2017. Intestinal Fungal Dysbiosis Is Associated With Visceral Hypersensitivity in Patients with Irritable Bowel Syndrome & Rats. Gastroenterology. Oct;153(4):1026-1039. Available from https://pubmed.ncbi.nlm.nih.gov/28624575/
Sugiyama & Shiotani, 2021. The Cutting Edge Research of Functional Gastrointestinal Disorders in Japan: Review on JGA Core Symposium 2018-2020. Digestion. 102(1):6-11. Available from https://pubmed.ncbi.nlm.nih.gov/33080599/
Hollister et al., 2020. Relationships of Microbiome Markers with Extraintestinal, Psychological Distress and Gastrointestinal Symptoms, and QOL in Women with Irritable Bowel Syndrome. Journal of Clinical Gastroenterology. 54(2):175-183. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387862/
Vacaras V, Muresanu DF, Buzoianu AD, Nistor C, Vesa SC, Paraschiv AC, Botos-Vacaras D, Vacaras C, Vithoulkas G. 2023. The role of multiple sclerosis therapies on the dynamic of human gut microbiota. J Neuroimmunol. May 15;378:578087. Available from: https://pubmed.ncbi.nlm.nih.gov/37058852/
Peckham et al., 2014. Interim results of a randomised controlled trial of homeopathic treatment for irritable bowel syndrome. Homeopathy. Jul;103(3):172-7. Available from https://pubmed.ncbi.nlm.nih.gov/24931748/
Billings et al., 2020. Potential Benefit With Complementary and Alternative Medicine in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology: the official clinical practice journal of the American Gastroenterological Association. Sep 19:S1542-3565(20)31296-9. Available from https://pubmed.ncbi.nlm.nih.gov/32961342/
Scaciota et al., 2021. Interventions for the treatment of irritable bowel syndrome: A review of Cochrane systematic reviews. Arquivos de Gastroenteroliga. Jan-Mar;58(1):120-126. Available from https://www.scielo.br/j/ag/a/Ky4jb7vB5ntYRfZYZgJxX5d/?lang=en
Peckham et al., 2019. Homeopathy for treatment of irritable bowel syndrome. Cochrane Database Systematic Reviews. Sep 4;9(9):CD009710. Available from https://pubmed.ncbi.nlm.nih.gov/31483486/
Pacheco et al., 2019. What do Cochrane systematic reviews say about the management of irritable bowel syndrome? Sao Paulo Medical Journal. May 8;137(1):82-91. Available from https://www.scielo.br/j/spmj/a/CKGfwTGgHcbvRtSn49qMRvx/?lang=en
Das et al., 2023. Efficacy of individualized homeopathic medicines in irritable bowel syndrome: A double-blind randomized, placebo-controlled trial. Explore (NY). Jul-Aug;19(4):519-527. Available from: https://pubmed.ncbi.nlm.nih.gov/36307315/
Vithoulkas, G. Levels of Health, The second volume of the Science of Homoeopathy, revised edition. Alonissos: International Academy of Classical Homoeopathy; 2017.
Mahesh et al., Individualized homeopathic therapy in ANCA negative rapidly progressive necrotising crescentic glomerulonephritis with severe renal insufficiency – a case repot. J M Life. [Internet]. 2019. [cited 2023 Feb 08] Jan-Mar;12(1):49-55. Available from https://pubmed.ncbi.nlm.nih.gov/31123525/
Vithoulkas G, Carlino S. The "continuum" of a unified theory of diseases. Med Sci Monit. 2010 Feb;16(2):SR7-15. PMID: 20110932.
Vithoulkas G. 2021. An integrated perspective on transmutation of acute inflammation into chronic and the role of the microbiome. J Med Life. Nov-Dec;14(6):740-747. Available from: https://pubmed.ncbi.nlm.nih.gov/35126742/
Mahesh S, Mallappa M, Vacaras V, Shah V, Serzhantova E, Kubasheva N, Chabanov D, Tsintzas D, Jaggi L, Jaggi A, Vithoulkas G. 2024. Association between Acute and Chronic Inflammatory States: A Case-Control Study. Homeopathy. Feb 9. Epub ahead of print. Available from: https://pubmed.ncbi.nlm.nih.gov/38335996/
Greenland, J. 2017. Marginalising homœopathy: an Australian case study. Prometheus. 35(3):171-192. Available from: https://www.scienceopen.com/hosted-document?doi=10.1080/08109028.2018.1472361
Salter et al., 2020. Sustaining homeopathy in Australia: Results and Analysis of the First National Practice Survey. Similia, The Australian Journal of Homeopathic Medicine. 32:1. The Australian Homeopathic Association. Hobart.